(UNKNOWN): I cannot at this point in time honestly give you a
straight yes-or-no answer.

BOEHNER: Let's kill the bill.

KARL: Will the Democrats have the votes?

(UNKNOWN): There's no way they can pass this bill.

(UNKNOWN): We believe we have the votes.

KARL: The latest from the chair of the Democratic caucus, John
Larson, and House Republican Whip Eric Cantor.

And the president's men. David Plouffe, the man who ran Obama's
campaign, and Karl Rove, the architect behind Bush's campaign, together
for the first time to debate health care reform and the midterm
elections (inaudible) "This Week" exclusive.

LETTERMAN: Tiger Woods coming back to golf, ladies and gentlemen.
The Masters in April. Tiger wants another green jacket. He left the
other one in a Las Vegas motel.

(END VIDEO CLIP)

ANNOUNCER: From the heart of the nation's capital, "This Week" with
ABC's congressional correspondent Jonathan Karl, live from the Newseum
on Pennsylvania Avenue.

KARL: Good morning. One of the most far-reaching bills in modern
American history hangs in the balance this morning, and a handful of
wavering Democrats will decide whether to vote for health care reform or
let the president's signature issue die on the House floor.

We are joined this morning by two members of Congress keeping track
of the vote count, John Larson, the chairman of the Democratic caucus,
and, of course, Eric Cantor, the Republican whip.

So, Chairman Larson, where are the votes?

LARSON: We have the votes. We are going to make history today.
Not since President Roosevelt passed Social Security, Lyndon Johnson
passed Medicare, and today, Barack Obama will pass health care reform,
demonstrating whose side we're on.

KARL: But let me pin you down.

LARSON: Go ahead.

KARL: You have the votes now?

LARSON: We have the votes now.

KARL: You have 216...

LARSON: As we speak.

KARL: ... commitments now?

LARSON: Yes.

KARL: Do you believe him?

CANTOR: Well, Jonathan, let me tell you something. The American
people don't want this to pass. The Republicans don't want this to
pass. There will be no Republican votes for this bill. And, frankly, I
think if it does pass, it's because they're using everything in their
political power and even some things they shouldn't have in their
political power to cut political deals...

KARL: Like what?

CANTOR: ... to deliver the votes. Well, certainly, you have seen
the kind of political kickback deals that have occurred. You've got
states like Louisiana that are going to receive $300 million more for
their health care than any other state.

And yet, if you look at sort of the comparison for this Louisiana
purchase versus what Thomas Jefferson paid for Louisiana and do the
analysis, this Louisiana purchase costs more than that original
one-fifth of the land mass of this country. Those are the kind of
political kickbacks that have facilitated this bill.

And the American people are just tired of it. And, you know, I hear
all the...

LARSON: The only political kickbacks that are common are to people
like Natoma Canfield, who became the poster for the American people
today. What's happening in terms of people being denied because of
pre-existing condition, having insurance policies rescinded in a gurney
on their way to the hospital.

We have Dennis Moore in our caucus stand up and was getting an
e-mail as he was speaking about a staffer who's just been diagnosed with
cancer who will lose her coverage after he leaves Congress. This is
what's...

(CROSSTALK)

LARSON: ... with the people in this country. That's the process...

KARL: I mean, the (inaudible) talk about these deals (inaudible)
Nebraska came out or will come out with this reconciliation bill, but
Louisiana's still in there.

CANTOR: Connecticut...

(CROSSTALK)

KARL: There's a new one for a North Dakota bank. I mean, why is that?

LARSON: What the -- what the American people want to see is a
up-or-down vote after a year of debating this issue, after several
decades of debating this issue. It comes down to, whose side are you
on? Are you siding with the insurance industry or are you siding on
behalf of the people who have been waiting decades for this passage?

CANTOR: Jonathan, that is a false choice, OK? The people...

(CROSSTALK)

CANTOR: The people -- the people of this country don't like this
bill. There's a reason why it's taken so long. There's a reason why
there's all this arm-twisting going on. And at the end of the day, if
this thing does pass, the American people are going to be outraged.
They are scared about this bill.

KARL: Well, let's listen. Of course, President Obama came and
addressed your caucus yesterday. Let's listen to what he had to say.

(BEGIN VIDEO CLIP)

OBAMA: And this is one of those moments. We are not bound to win,
but we are bound to be true. We are not bound to succeed, but we are
bound to let whatever light we have shine.

(END VIDEO CLIP)

KARL: Chairman Larson, how many Democratic House members are going
to lose their seats as a result of this vote?

LARSON: Well, every time you have a midterm election, you risk the
chance of losing members, but it isn't about how many members are going
to lose their seat. What the president said is right. It's about this
moment. It's about the truth. It's every reason why you were elected
to come and serve in Congress.

You have 47 million Americans...

(CROSSTALK)

LARSON: ... that don't have insurance, 14,000 dying a day. Excuse
me, losing their insurance a day, thousands that are dying throughout
this country because of lack of health care.

KARL: Some will lose their seats, though, as a result of this bill,
right?

LARSON: That's quite possible.

KARL: Let me ask you about the way your -- your leader, the
Republican leader, talked about this vote just yesterday.

KARL: OK, Congressman Cantor, come on. Is this bill going to ruin
our country today if it passes?

CANTOR: Jonathan, what is going on from my perspective is the
American people are full of fear about this bill. They see that this
bill will take Medicare benefits from seniors. That's a scary thought.
They see...

KARL: OK, but is this going to ruin our country?

CANTOR: Jonathan, it is about the fear. There is a better way, but
that -- that's what's going on.

KARL: But I'm asking a specific question. I mean, we heard from
the Republican leader in the House say that this is Armageddon, it's
going to ruin the country. We have the vote tonight.

CANTOR: This is a bad bill that people are frightened -- they're
frightened that they're losing their jobs right now, and here we're
going to tax small businesses to the tune of $2,000 per job? You've got...

KARL: Does that ruin the country?

CANTOR: You've got folks -- you've got families thinking, how are
we going to pay for the trillion-dollar debt that is going to occur from
this bill alone? And how are our children going to pay for it?

What it is, Jonathan, it is about trying to attack the American
ideal. That's what's going on with this bill. People are beginning to
think they won't have the life that they've had for their children.
That's what's going on. And I think that's...

(CROSSTALK)

LARSON: ... Social Security. I respect the fact that they want to...

CANTOR: Come on.

LARSON: That's true.

(CROSSTALK)

LARSON: Here's the thing. Here's the thing. Everybody ought to
ratchet back just a little bit. And when you have two members of
Congress, two respected members of the Congressional Black Caucus spat
on and hurled epithets that were just...

KARL: Racial epithets.

(CROSSTALK)

LARSON: ... that were horrible, horrible.

CANTOR: Jonathan -- Jonathan, nobody...

(CROSSTALK)

CANTOR: ... nobody condones that at all. There were 30,000 people
here in Washington yesterday. And, yes, there were some very awful
things said.

(CROSSTALK)

CANTOR: But, I mean, come on. Nobody condones that kind of...

(CROSSTALK)

KARL: Is it time to ratchet it back a little bit...

(CROSSTALK)

LARSON: ... ratchet it back.

(CROSSTALK)

CANTOR: You know -- you know what it is time for? It's time to
listen to the American people, and that is the stunning thing about
this. You know, John said that there -- there will be some members who
will lose their seat. This is a legacy vote; there's no question about it.

LARSON: It is.

CANTOR: It's a legacy vote...

KARL: On that note of agreement, we are -- we are out of time. And
we'll be watching. You've told us you already have the votes. We'll be
watching to see if you're right.

KARL: Joining me now, David Plouffe, President Obama's campaign
manager, who the president brought back just a few months ago to plan
strategy for Democrats heading into the midterms. He's also the author
of "Audacity to Win."

And in Indianapolis, Karl Rove, the architect of President Bush's
successful campaigns for president and the author -- we have your book,
as well, Karl -- "Courage and Consequences."

So, David, listening to some of the analysis today, you would think
we are either in the last six hours of the Obama presidency as we know
it or the beginning of the great Obama comeback. What are the stakes
here today?

9:09:43

PLOUFFE: Well, first of all, we ought to focus on not the political
stakes, but the stakes for the country, and we are not going to succeed
as a country economically if we don't do the right kind of health care
reform, and we're on the verge of passing something here that's going to
help grow jobs, help save families and businesses money, going to end
the donut hole that seniors have to pay for prescriptions.

But I think the politics of this, by the way, we pass this, we're in
much better shape politically as a Democratic Party than we are today,
because we're going to go out there and not just talk about what we're
for, but what the Republicans are voting against.

They are siding with the insurance companies over people who are
denied coverage for pre-existing conditions, siding with the insurance
companies over saving seniors money.

So this isn't just about us being a pinata here in the election.
Elections are about choices. They are voting against an enormous tax
cut for health care for 40 million middle-class families and 4 million
small businesses. That's what they're opposing here.

9:10:29

KARL: Just quickly, on the politics, if you lose this vote, do you
lose the House?

9:10:34

PLOUFFE: Oh, listen, we're 30 weeks away. I think -- I've been
very clear about this. We are going to much better positioned
politically -- now, that's secondary to what's right for the country --
if we pass this.

By the way, we had 15 million new voters vote in the 2008 election,
OK? These are people who are cynical that their vote really mattered.
If we don't pass health care, I think that sends a very depressing message.

But it's going to be a very powerful message to them that their vote
mattered and they ought to stay involved in politics, and it can make a
big difference in this country.

9:11:00

KARL: Now, Karl, the president spoke about you when he went to talk
to the Democrats yesterday. Here's what he had to say.

(BEGIN VIDEO CLIP)

OBAMA: I notice that there's been a lot of friendly advice offered
all across town.

(LAUGHTER)

Mitch McConnell, John Boehner, Karl Rove. Now, it could be that
they are suddenly having a change of heart and they are deeply concerned
about their Democratic friends.

(END VIDEO CLIP)

KARL: Now, Karl, do you seriously believe that Democrats are better
off if this does not pass?

9:11:33

ROVE: Look, I think the country is better off if this thing doesn't
pass. This thing is $2.4 trillion for the first 10 years of its
operation. This thing has 10 years' worth of -- of tax increases, $569
billion in tax increases, including $210 billion in a new payroll tax
and a new 3.8 percent surtax on investments that's going to make us less
competitive, $500 billion-plus in Medicare cuts to pay for, in essence,
four complete years of the operation of this program.

The subsidies don't begin until year four and are not fully
operational until year 10. If you look at the first 10 years of the
operation of this thing, it is $2.4 trillion, and this thing is paid for
by Bernie Madoff-style accounting in which they double-count money and
ignore enormous costs. They claim $138 billion of deficit reduction,
but it's either between $480 billion in debt -- in deficits added to the
-- to the red ink...

KARL: So...

ROVE: ... if you just look at what they double-count, and it's $720
billion if you count what they ignore in here. These people are
double-counting $53 billion worth of Social Security revenue twice, once
for Social Security, once to pay to this program; $70 billion for the
new long-term care premium, they count it for the premium program and
then for paying for this program. They count $500 billion worth of
Medicare cuts twice. They ignore $208 billion in Medicare doc fixes
that they just put off to the side and said we'll -- we'll pay for that
later and $30 billion in Medicaid doc fixes.

This thing is not $138 billion in the black. It is either $480
billion, if you look at what they double-count, or $720 billion in
deficit in the first 10 years if you take what they ignore.

KARL: So, David...

ROVE: This thing is a gigantic disaster.

9:13:16

KARL: ... Bernie Madoff accounting, a gigantic disaster?

9:13:19

PLOUFFE: Well, you know, listen, Karl and the Republicans would be
familiar with that, since under their leadership, they took us from big
budget surpluses at the beginning of the last decade to a $1.3 trillion
deficit by not paying for things like the prescription drug plan, two
wars, big tax cuts.

So, no, this is -- the Congressional Budget Office is very clear.
Over the next two decades, this is going to cut the deficit by over a
trillion dollars.

9:13:42

ROVE: But -- but...

(CROSSTALK)

PLOUFFE: A trillion dollars.

(CROSSTALK)

9:13:46

ROVE: ... cuts the deficit, it only cuts the deficit if you
double-count, as you double-count $53 billion worth of Social Security
payroll taxes twice, if you double-count $500 billion in Medicare cuts
twice, once for reducing the cost of the $38 trillion unfunded liability
in Medicare and, at the same time, for the current expenditures in this
program, and if you double-count $72 trillion in premium payments for a
new long-term care entitlement program twice, once for premium payments
for the program and once for this.

Look, you have run up more deficit before this bill in the first 20
months and 11 days of your term in office than was done in the entire
Bush years. Your plan is to take the deficits, which were 2 percent
under George W. Bush, to 5.1 percent over the next 10 years under Barack
Obama.

Don't be lecturing us about what you're doing with the profligate
spending that started last year with the failed stimulus bill and
continued with your budget increases. You have increased the
discretionary domestic spending budget in the United States 25 percent
starting in the middle of the last fiscal year.

This is $2.4 trillion in cost for its first 10 years, and the
country cannot afford it, and you will bankrupt the country if this bill
passes.

9:14:49

KARL: I think Karl's against this bill. But isn't -- isn't there a
point, though -- I mean, there -- there is some interesting accounting
here. I mean, the Medicare doc fix, for instance, is not in here.
That's a couple hundred billion dollars. I mean, isn't it hard as a
political factor for people to believe that a big new health care
program is actually going to cut the deficit?

9:15:09

PLOUFFE: Well, first of all, Karl, the Republicans have zero
credibility, about as much credibility as the country of Greece does, to
talk about fiscal responsibility.

9:15:16

ROVE: This is -- this is the CBO.

PLOUFFE: Well...

9:15:17

ROVE: These numbers are in the analysis from the CBO. For God's
sake, will you stop throwing around epithets and deal with the facts for
once, David?

KARL: Karl...

ROVE: What about double-counting 53, 70 and 500? What about
leaving out $208 billion for Medicare doc fix? What about leaving out
$30 billion for the Medicaid doc -- for the doc fix? You've got two
years' worth of a Medicaid doc fix. Are you telling me that in two
years you're going to cut overnight the doc -- the doc reimbursement and
not pay it for the balance of the eight years of this program?

9:15:44

KARL: Let -- let...

(CROSSTALK)

9:15:48

PLOUFFE: Let's put the fanciful chart away, OK? This is -- the CBO...

ROVE: This is not a fanciful chart. Deal with the charts.

PLOUFFE: Karl...

(CROSSTALK)

ROVE: These are the facts, David.

PLOUFFE: ... every...

ROVE: What about double-counting?

(CROSSTALK)

9:15:58

KARL: Let's give him a chance to answer.

PLOUFFE: I'm trying to. The -- the CBO major economists who've
looked at this health care reform, very clear that this in this decade
is going to lower the deficit and in the next decade, over $1 trillion.
What the American people are focused on -- what we need to be focused on
are the health care costs, premiums skyrocketing.

We are not going to solve these problems unless we have meaningful
health insurance reform, and that's what we're going to do. And,
listen, the Republican Party, if they want to run in this election and
the elections of this next decade against reducing the deficit by over
$1 trillion, against the insurance company reforms...

9:16:41

(CROSSTALK)

PLOUFFE: ... against saving money...

(CROSSTALK)

9:16:44

ROVE: Within two months -- within two months, the Democrat Congress
is going to be forced to deal with the doc fix. They're going to bring
up a Medicare doc fix that's going to be $208 billion, according to a
CBO analysis of it, issued two days ago.

KARL: OK.

ROVE: We will see very -- very soon how much they're committed to
fiscal discipline when they pass a doc fix without an offset that adds
$208 billion to the deficit and when we start to see them continue to
double-count.

KARL: All right.

ROVE: I like it that David never dealt with the issue of
double-counting and never dealt with these other issues. We will see if
they pass this bill. I hope they don't. I pray they don't. It will be
an economic disaster for the country if they do.

9:17:18

KARL: Let's look at the political pressure these wavering Democrats
are. And, look, let's face it. This is all about convincing Democrats
now, because you won't get a single Republican vote. But you have one
of your strongest union allies, SEIU, running this ad against those who
are voting no.

(BEGIN VIDEO CLIP)

(UNKNOWN): By voting for health care reform, Arcuri will reduce
health care costs for families and small businesses and stop insurance
companies from getting rich by denying coverage and hiking premiums.
Call Congressman Arcuri. Tell him to stand up for us, not the insurance
companies.

(END VIDEO CLIP)

KARL: Now, Congressman Arcuri is a Democrat who has said he is
going to vote no. Isn't it a little bit kamikaze for your allies to be
going out and targeting Democrats who are going to face very tough races
in the midterms?

PLOUFFE: Listen, people feel very strongly about this issue. And
we sadly are going to have to do this alone as a Democratic Party, but
it's our moment to lead. And I do think, in the short term and in the
long term, this is going to be seen most importantly for the country,
but the politics for our party -- because, again, politics are about
comparisons.

And so I think that we are going to -- listen, for a variety of
reasons -- we've got a tough economy. We've run a lot of races, so
we've got a lot to defend. We're going to have a tough election. But I
think our election outcome in 2010 can be a lot better than a lot of the
pundits think by passing health care...

KARL: But is it -- would you ask your union allies to back off and
not to target -- these are the most vulnerable Democrats in the House
right now, and tell them not to be running against them? I mean, you
have already threats to rescind endorsements, to endorse independent
candidates. Is it time for the unions to back off?

PLOUFFE: Well, listen, I think we're trying to get the votes to
pass health insurance reform. And we're not there yet. Obviously,
we've still got the vote to take place, but it looks like we're getting
very close.

I think, once the vote's over, obviously, we're going to go out
there and figure out how to help Democrats win elections, and I think
we're going to have a much better election...

(CROSSTALK)

KARL: Including those that voted no? Are you going to help those
that voted no win the election?

PLOUFFE: Of course we are. A lot of us supported on the Recovery
Act, on the energy bill. They'll have to make their own case to their
constituents and volunteers in their district about why they...

(CROSSTALK)

KARL: So you'd be going up against the unions in some of these races?

PLOUFFE: Listen, I think we -- you know, it's going to depend race
by race, but I think we're committed -- a lot of these people who don't
vote for health care -- by the way, we're getting a majority of the
Democratic caucus in both the House and the Senate for health insurance
reform, as we did for the Recovery Act, as we did (inaudible) and, by
the way, this is a big moment in our country.

Economic calamity, we've got these long-term problems like health
care and energy that will determine our future. The Republican Party
for the most part is not lifting an oar to help row. And I think...

(CROSSTALK)

ROVE: ... that is bunk. That is complete bunk. Republicans have
offered a positive alternative on health care, and you didn't bother to
have one meeting between March 5th of 2009 and February 25th of 2010 to
discuss how the White House could involve some of those Republican ideas
in the bill.

Don't give us that bunk. That is another one of those false
arguments offered by the White House. In fact, you know what? The way
that you have sold this bill to Democrats by threatening them, you
cannot tell me that the White House didn't sanction some of these groups
like MoveOn.org and others to make these kind of threats against Democrats.

We do know that the White House sent out unsolicited e-mails to
federal employees asking them to contact their legislators about this
bill. I think that's not only a violation of the CAN-SPAM Act on
e-mails, I think it's a violation, more importantly, of the
anti-lobbying statutes. And that's the kind of techniques that you've
been using on this bill, threats, hardball politics, and if need be,
withholding federal -- the support of the president of the United States
from Democrats.

You said earlier this week -- the White House did -- that the
president would be campaigning actively and raising money for Democrats
who supported that bill. That is a thinly disguised bribe.

KARL: Is that right?

PLOUFFE: This is just outrageous. No. The president has been...

(CROSSTALK)

ROVE: Look in the newspapers, man. Look in the newspapers.

(CROSSTALK)

ROVE: The White House political office leaked it to the press,
saying the White House policy will to provide the president to go
campaign for...

(CROSSTALK)

KARL: ... campaigning for...

ROVE: That is a thinly described bribe.

KARL: OK, so the president will be campaigning for Democrats who
vote no?

PLOUFFE: I'm sure he'll be out there helping people who vote yes on
this, who vote no on this, people who voted yes on the Recovery Act,
which, by the way, Karl claimed is a failed program. The economy's
growing.

(CROSSTALK)

ROVE: ... jobs have been lost...

(CROSSTALK)

PLOUFFE: ... because of this.

ROVE: That's right, government jobs, government jobs. You promised
us...

(CROSSTALK)

ROVE: ... private sector. You promised us 4 million jobs.

(CROSSTALK)

ROVE: ... million have been lost since that bill...

KARL: Let's get him to respond.

PLOUFFE: So, no -- but, listen, you want to talk about the fall
elections, OK? We're going to have a great debate, OK? It's going to
be about health care reform, and I think that's a debate that we are
positioned to win. It's also going to be about -- listen, people have a
very clear memory about what it was like under Republican leadership, OK?

The debt -- the policies that created huge deficits that devastated
the middle class -- you've got the leader of the House Republicans...

ROVE: David is right -- David is right that we...

(CROSSTALK)

ROVE: ... they have lost over the last year...

(CROSSTALK)

PLOUFFE: The leader of the House Republicans, who would be the
speaker if they won, has been shaking down Wall Street, saying, "Hey,
we're the guys trying to protect you"...

ROVE: This -- this election will be about health care, if this bill
passes...

(CROSSTALK)

KARL: Karl, we're almost out of time. I want...

(CROSSTALK)

KARL: ... respond to something.

ROVE: This is a debate the Democrats have lost.

KARL: OK, I want to get both of you to respond to something. This
is a poll that came out about what Americans think about the process
here, and this is a Kaiser -- Kaiser Family Foundation poll about the
health care -- possibly getting health care passed. Only 19 percent say
they believe the process is working as intended, and 73 percent said the
process is broken. Frankly, I think a lot of Americans listening to
this debate right here might agree exactly with that 73 percent who say
the process is not working.

So my question to you, David, isn't that in some sense an indictment
of President Obama since he got elected promising to change this system?

PLOUFFE: Well, he's trying to. First of all, in almost every poll
out there, well over 60 percent of the American people believe that
President Obama is trying to work with the Republicans. The Congress --
it's true. Well over (ph) 60 percent of the people believe the
Republicans aren't reciprocating. And worse than that, it's not because
of principle. They believe it's because of raw, naked politics.

So he's trying. He's making his executive branch more transparent,
lessening the influence of lobbyists, so he's going to continue -- by
the way, on immigration, on education, on some of the energy ideas, I
think we have an opportunity to work in a bipartisan fashion, and he's
going to look for that opportunity each and every day.

KARL: Karl, we're almost out of time...

(CROSSTALK)

ROVE: This is an indictment of the president. He held a bicameral,
bipartisan meeting on March 5th of 2009 to talk with people about health
care reform. The next time he had a substantive meeting with
Republicans to talk about health care reform was the Blair House kabuki
drama on February 25th of 2010.

You cannot go for 51 weeks shutting the Republicans out of the
debate and claim that you provided leadership. He has been aloof,
distant, detached. This bill is based on Bernie Madoff economics and
includes things that he campaigned against Hillary Clinton and Bill and
-- and John McCain on during the campaign. And it is a bad bill for
America.

KARL: All right.

ROVE: And we will fight the election on this, and the Democrats
will have significant losses in the House and Senate as a result of this
bill.

KARL: You have 10 seconds.

PLOUFFE: Well, listen, Karl and a lot of Republicans want to call
the election all over. They ought to break out that "Mission
Accomplished" banner they put on the USS Abraham Lincoln, OK?

(CROSSTALK)

ROVE: ... that is cheesy, David...

(CROSSTALK)

ROVE: ... honoring the USS Abraham Lincoln for the -- for the
longest mission...

(CROSSTALK)

KARL: Karl Rove...

ROVE: ... aircraft carrier in American history. And you should not
denigrate the mission of the...

(CROSSTALK)

ROVE: ... like you've just did.

KARL: Karl Rove, joining us from Indianapolis, Karl, thanks for
joining us on "This Week." David Plouffe...

PLOUFFE: Thank you.

ROVE: ... thank you very much. I think we'll be debating this some
more.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

DASCHLE: As we profess the desire and the need for bipartisanship,
we have a process that is this inexcusable on an issue this important.
I think it is fair to say -- and I don't know that any Republicans would
ever dispute it -- the Democrats were virtually locked out from the
beginning on this issue.

LOTT: I've tried every way in the world to try to get us to have a
bipartisan bill out of the Finance Committee. That was denied. Tried
to get something done before it got to the floor, working with the
centrist groups, that was denied.

(END VIDEO CLIP)

KARL: Those are two former Senate leaders nearly a decade ago
sounding an awful lot like the current Senate leaders, and they are both
here with us on the roundtable.

We have, of course, George Will, former Majority and Minority Leader
Trent Lott, former Majority Leader and Minority Leader Tom Daschle, and
my friend, Sam Donaldson.

So, George, put this day, this vote, its significance in a
historical context.

WILL: Here's the context. Today, as happened yesterday and as will
happen tomorrow, and as will happen every day for the next 20 years,
more than 7,000 baby boomers will retire, going on the Social Security
and Medicare rolls, increasing the pressure on our Ponzi system we call
our entitlement programs.

This at a time when we're -- we're now about to -- probably right up
the street from here today -- going to add 32 at least million more
people with a middle-class entitlement involving subsidizing health care
insurance purchases for families of four up to $88,000 a year.

Now, Democrats who will vote in the House today for this think
they're going to put it behind them. The odds are very good, after the
reconciliation procedures are done in the Senate, that it will come back
to the House, so we're going to be wallowing in health care for a long
time to come.

And, finally, once this is passed, the American people will look at
the health care system and say, "This is the system the Democrats
wanted," so every complaint they have is going to be a complaint about
Democrats.

DONALDSON: Can I jump in before the majority leaders?

KARL: Sure.

DONALDSON: That is the weakest argument for keeping 32 million
Americans still off of health care, for making them go to the emergency
rooms, shifting the cost to the rest of us who have some sort of
insurance, the fact that we can't help our fellow citizens because we're
not a rich enough country to pay for it. That's silly, George.

KARL: But before we get to the leaders, let's take a look at the
entitlement programs, the two other big votes this has been compared
to. OK, we have 1965 and the Medicare vote. It passed the House
313-115, with a significant portion of the Republican caucus voting yes,
and 1935, Social Security, 372 yes, just 33 no, the majority of
Republicans joining Democrats and voting yes. What happened this time,
Senator Daschle?

DASCHLE: Well, I think, in part, it's a different Republican Party
than it was. I mean, it's a Republican Party that really doesn't have
the same commitment that the same Republicans had in other -- other
decades.

I mean, I -- I -- I had the good fortune to work with two
Republicans -- Howard Baker and Bob Dole -- who worked very
constructively over the last 18 months to come up with a bill that they
endorsed, very similar to the plan that we have before the Congress today.

So I think, in part, it's just a much more rigid, far more
ideological party than -- than before. And I think that's been playing
itself out now for the last couple of years.

LOTT: I can say exactly the same thing the other way. This is a
very dogmatic, ideologically committed Democratic Party. The leaders
decided, "We've got the votes. We're going to ram this through. We're
going to ram it through the House, getting one Republican vote, and
through the Senate, getting in the final analysis no Republican votes."

There was no effort to try to make this a bipartisan bill. Look,
there are some good parts in this bill that could have been passed in
pieces. Everybody agrees there needs to be some insurance reform.
There are some other areas where I think they could have come together.

In May of last year, there was actually a Republican effort to reach
out and say, "Let's sit down and see if we can come to agreement on a
number of these things," and were told, basically, "Thanks, but no
thanks."

Look, this is -- this is a huge bill that's going to dramatically
change how the American people get their health care. Now, look, yes,
you would like to have more people covered, but in covering 32 million
people more and saying, by the way, we're going to cut taxes and we're
going to reduce the deficit, it defies common sense. You cannot do all
of that.

DASCHLE: But the CBO, Jon, says exactly that, that they've scored
this bill. They've -- they've indicated that not only is the federal
government going to save $600 billion, but in the second decade, we're
going to save $1.3 trillion.

Now, the CBO is the referee. We can differ with it. And those on
the right will continue to object to CBO's score. But the score is the
score. It's the official referee, and we've got it now in black and
white.

WILL: But what the CBO does is takes Congress's promises at face
value. Now, let me ask the two legislators here. Do you really believe
that the tax on the Cadillac -- the high-value health insurance programs
-- that has been kicked down or will be kicked down the road to 2018, do
you really believe that will ever be enacted?

LOTT: No.

WILL: Who here believes that the Medicare cuts are going to be made?

LOTT: It will not happen.

WILL: CBO has to assume that, but we're grownups, and we don't.

LOTT: And, by the way, the doctor fix...

KARL: In fact -- in fact -- in fact...

LOTT: The doctor fix, which they'll have to do, because it -- you
know, doctors will be cut by 21 percent unless Congress changes it this
fall.

KARL: In fact, we had an article in the New York Times by a former
CBO director, by Doug Holtz-Eakin. Now, of course, he's a Republican.

DASCHLE: John McCain's campaign manager.

KARL: John -- I understand, but somebody that knows a little bit
about a CBO (inaudible) and he talked exactly on this point. He said,
in reality, if you strip out all the gimmicks and budgetary games and
rework the calculus, a whole different picture emerges. The health care
reform legislation would raise, not lower, federal deficits by $562 billion.

DONALDSON: Well, here's the thing about saying future congresses
will be weenies, pardon the word, and they won't, in fact, do this.

KARL: There's a good record of that.

DONALDSON: Well, there's a good record of it. But look what's
going to happen here. There will be an imperative on the hands of
future congresses if they don't like these particular tax increases,
they don't like these particular cuts, to do something. They can't just
let it go. I think the body politic wouldn't stand for that.

And from the standpoint of this bill, changing America, which a lot
of the opponents say, Trent, you can still have your own doctor, just as
you have now. You have a health care plan you like now? You can still
have it.

LOTT: What if the doctor says, no, I'm not going to take anymore
Medicaid patients or I'm not going to take any more Medicare patients?
And that's already beginning to happen.

DASCHLE: But they're -- but they're doing that now. And the status
quo is simply unsustainable. We can't sustain the cost, we can't
sustain the problems with regard to quality. We can't sustain virtually
any aspect of health care as it's now delivered in this country.

LOTT: And, by the way...

(CROSSTALK)

LOTT: Let me jump in here with this, too. You mentioned Medicare
and Social Security, both very popular, very important parts of our
fabric in America, but both of them are in financial difficulty. Here
we are, putting more weight on Medicare at a time when it's already
facing tremendous problems because of the baby boomers that are coming
along.

DONALDSON: But George is quite correct. Because of the demography
of the country and the way it's changing, yes, we have to fix these
things.

LOTT: When are we going to do it?

DONALDSON: Well, you're going to do it because you have to do it as
we go along.

LOTT: We've been having to do it for the last 10 years. We didn't
do it.

DONALDSON: That's right. And we fixed Social Security, apparently,
in the early '80s. We had to fix it again. We may have to fix it down
the line, Trent, but that's no reason to abandon it or abandon this kind
of health care.

WILL: Tom talks about costs. One of the first and most predictable
consequences of this bill is going to be that health insurance premiums
are going to go up. They have to, Tom. We're changing the risk pool.

Once you say to people -- to insurance companies that they cannot
discriminate against people who have pre-existing conditions, then when
you bring the risk pool in, all these people who already have troubles,
you're going to have the premiums go up. That's the first...

(CROSSTALK)

KARL: But it's also requiring you to have insurance...

(CROSSTALK)

DASCHLE: But George is right about premiums. I mean, there --
there -- there are issues involving premium, but what he hasn't
mentioned is the increased transparency, the fact that we're finally
going to get away from rewarding volume. We're going to start rewarding
value.

We're going to have delivery reform for the first time. We're going
to be dealing with the structural problems in our health care system for
the first time in history. And those are, by -- again, by CBO account,
going to have a profound effect in bringing costs down, not -- not
raising them.

LOTT: Let me make one other point here. I know process in
Washington consumes us, and the average American out there is saying,
"What is all this?" But I have never seen such a contorted process to
try to get a bill through the House, through the Senate. They talked
about just deeming the bill passed. At least they were wise enough
yesterday to back away from deem and pass, even though you didn't vote
on it, and now it's going to go back to the Senate for reconciliation.
Now, I used reconciliation, but not like this.

DASCHLE: Trent knows procedure as well as anybody in Washington,
and he knows that the Republicans are very masterful, if they want to
be, just as Democrats were in the minority, at stopping virtually every
procedural opportunity there was, so...

KARL: All right. Let me -- let me get to...

(CROSSTALK)

DASCHLE: How can the Republicans be complaining about process when
they themselves have put them -- put their bodies in front of that
legislative process for the last 18 years?

KARL: Let me -- let me...

DONALDSON: It's a different ox to be gored. That's the thing.

KARL: Let me get to the next step, which is the Senate.

DONALDSON: You're the boss. You go right ahead.

KARL: I mean, this supposedly is not over, right? I mean, this
reconciliation fix still has to pass in -- in the Senate. And many of
those House Democrats that are going to vote yes today are doing so
because they have been assured that it will pass in the Senate.

LOTT: They can trust the Senate.

KARL: I spoke to Senator Mitch McConnell about this, and here's
what he had to say.

(BEGIN VIDEO CLIP)

MCCONNELL: I think any House Democrat who votes for this bill
thinking the Senate is going to clean up the mess is delusional. Plus,
they're trusting the Senate to clean up the mess. As Lamar Alexander,
one of my colleagues put it, you know, it will be walk off the cliff and
hope that Harry Reid catches you.

KARL: And is he going to catch them?

MCCONNELL: I don't think so.

(END VIDEO CLIP)

KARL: Senator Daschle?

DASCHLE: Well, listen, we're going to pass the reconciliation
package in the House. It's going to go to the Senate. There are 20
hours. Amendments can be offered. Procedural challenges can be made.
At the end of the day, the majority is going to rule, and Harry Reid has
-- has got the votes, and he's going to demonstrate that beginning this
week.

KARL: I found it interesting, he did release the letter, and it's a
letter, you know, giving the House Democrats assurance, and they tell us
that there are 51 signatures on the letter. But in what's been
released, the signatures are left off. It is a blank sheet of paper.

WILL: And is it -- is it not the case that if so much as a comma is
changed, it goes back to the House?

LOTT: That is correct.

(CROSSTALK)

KARL: And there's no way it goes through unchanged, is it?

DASCHLE: But this is a protected measure, that is, it is an
expedited procedure that allows the majority in the House, the majority
in the Senate, purely the majority. We've got supermajorities in the
House and the Senate. There's absolutely no reason why we wouldn't have
the votes necessary to pass reconciliation when it happens.

DONALDSON: Look, the bill is going to pass. Reconciliation is
going to pass. It's becoming the law. And then in November, people
will argue, as part of the off-year elections, about it. And down the
road, they will keep arguing. And down the road, it will have to be
fixed again.

If this bill, as I perceive it, were the only thing that's going to
pass and would never change, if I were in the Senate, I'd vote no, or
the House. But clearly, we have to take the first step. Tried for 100
years, couldn't do it, couldn't do it. Without a first step toward that
1,000-mile journey, you're never going to make it. Along the way,
you're going to have to change the steps, but without this first step,
we're ruined as a country.

LOTT: The only time I've ever seen the Congress turn tail and run
and reverse a bill that had just passed, you know what it was?

DONALDSON: Yes, I know exactly. In the House...

(CROSSTALK)

LOTT: ... health insurance.

DONALDSON: Exactly right.

LOTT: And we passed it in the fall, went home, got an earful, came
back the next year and -- and reversed it.

DONALDSON: But you remember that bill, don't you? It said that
older people needed to pay if they wanted catastrophic health insurance
if they had the money.

(CROSSTALK)

DONALDSON: And most of the older people who didn't wouldn't have to
pay, but elderly people who were wealthy would have to pay, and they
rose up in arms. "Don't you touch me."

KARL: Let me ask you, we've now just spent this entire show talking
about health care, and we looked back at the president's speeches over
the last month, and we put it in into a program that shows you a visual
representation of how many words, the big major subject lines he uses.
Take a look at this, if you can see. They call this is a word cloud.

And you can see, of course -- this is 35 speeches over the last
month, health, insurance, the big issues. Try to find jobs on that
little word cloud. I think we can help you if we have another graphic.
It's right up there. I mean, this health care has completely crowded
everything else out. You won't see a single mention in any of those
speeches of Afghanistan, of terrorism.

Has this been a cost that this has dominated not only the last
month, but it's dominated much of Obama's presidency so far?

DASCHLE: Well, it has, and it's by design. Clearly, this president
cares deeply about this issue. He has said to me it's his legacy, and
he understands the balance and the importance of this.

But he's also done an extraordinary amount of work in the other
areas, as well. We've made progress on the economy. You know, we're
doing very well in Afghanistan and Iraq right now. The elections just
were held. I mean, you look at all the other aspects of his presidency,
and I would say that, in spite of the fact that he may not talk about
them to the -- in rallies around the country, the fact is that we're
making progress.

This is where he's put his emphasis for a reason. Today is that
day. Today is when we're going to see health care passed.

LOTT: But the pattern goes beyond health care. We see just last
week there had been negotiations on so-called financial services
reform. There's been a lot of bipartisan effort going on with Senator
Corker, Senator Shelby, Senator Dodd, and others.

And all of a sudden -- under pressure, I believe, from President
Obama and from his left flank -- Chris Dodd said, eh, no more
negotiation, try to find bipartisan common cause. We're going to ram
this through without any Republican participation.

There is a pattern here. And I think it's -- they're paying --
they're going to pay a tremendous cost...

(CROSSTALK)

KARL: And we've heard from Lindsey Graham, who...

DASCHLE: But that isn't what Chris Dodd. Chris Dodd actually said,
I want to continue to work with Bob Corker and others, other Republican
senators. I mean, they -- he thought that -- I mean, he had called them
over to his home. He worked out details with task forces on a
bipartisan basis. I mean, Jack Reed is working with the Republican
counterparts.

LOTT: But why did they stop and you came up with a bill that
clearly is not going to make it through the process?

KARL: Well, one -- one of the few Republicans who has been working
on a variety of issues with -- with the president and with Democrats is
Lindsey Graham, and he has made no bones about it that he believes going
through with this process, this reconciliation process, is going to
destroy his efforts to work on health care -- I mean, on immigration, on
-- on the Guantanamo issue.

(CROSSTALK)

LOTT: On energy, too.

KARL: It's going to destroy it all, energy. I mean, Sam?

DONALDSON: Well, it's not going to.

KARL: It's not going to?

DONALDSON: Some Republicans -- some Republicans say that, if this
health care bill passes -- and I think it will -- that it will destroy
the country. Well, that's nonsense. It's not going to destroy the country.

KARL: Well, it's not going to destroy the country, but is it going
to destroy bipartisan? I mean, if you don't even have...

DONALDSON: What bipartisanship? At the moment, both these
gentlemen -- and the clip that you started our roundtable with --
demonstrates there's not much bipartisanship up there.

LOTT: But we were able to do it together in the '90s and working
with...

DONALDSON: You mean you and Tom?

LOTT: Yes, and -- and working...

KARL: I recall some fights, though, every once in a while.

LOTT: ... with the Democrats...

(CROSSTALK)

DONALDSON: ... history from the standpoint of some of those
colloquies on the floor of the Senate?

LOTT: Well, we did have our disagreements, but we also came
together on welfare reform, balanced budgets, surpluses, safe drinking
water, portability of insurance, big things in a bipartisan way.

WILL: The Democratic members of the House and Senate, their
appetite for difficult votes is now exhausted, which means the country
will -- and this is the good news about health care -- having sucked all
the oxygen out of this town, we are going to be safe from cap and trade
and we will be safe from a number of the other follies that would
require Democrats to continue casting suicidal votes.

(CROSSTALK)

DASCHLE: I really think, George, that you've -- each one of these
takes on its life, and they start developing the kind of momentum.
We're going to have an energy bill.

LOTT: Not this year.

DASCHLE: We're going to have a financial securities bill. Well, it
may not be -- it may not involve a capped system as -- as I would like
it, but you're going -- you're going to see progress on these other
important issues, I guarantee you. They all take on their own life and
their own momentum, and the next ones are coming, financial regulation
in particular.

DONALDSON: I agree -- I agree with George. You're going to take a
hit. The Democrats are going to take a hit in November. It maybe
mainly because of the economy, rather than the health care dispute, but
you're going to lose more than the off-year losses, and you're not going
to have the control in Congress that you have right now.

I think the president was wrong to try to say we'll take all the
islands at once instead of one island at a time, but he was right to
take the big island of health care. I think that's very important. But
I agree: You're not going to get a lot through.

WILL: The Wall Street Journal-NBC poll shows the job approval in
the country in Congress is 17 percent, which raises two questions. Who
are those 17 percent?

KARL: Yes, who are the 17 percent?

WILL: And, second, haven't we found a way in the last three or four
weeks to lower this approval? Now, I understand politics is a
transactional business, but some of the transactions in this -- are you
at all embarrassed about water suddenly being released to the California
valley because of health care?

DASCHLE: Well, I -- you know, you're going to see polarization.
And when that polarization continues as it has, people are -- are not
very enchanted with Congress. I mean, they want to see cooperation.
They want to be able to see some progress on some of the issues.

LOTT: The highest approval rating of the Senate...

DASCHLE: I guarantee you, once health care passes...

LOTT: ... was when we were working together after 9/11 in 2001.
The approval rating went up to 71 percent. Why?

KARL: It was an extraordinary time.

LOTT: Because people saw us working together to do the right thing.

KARL: Can I ask you -- we don't have much time. I've been wanting
to ask you this for some time. Harry Reid is facing -- he may be the
most vulnerable Democrat in the Senate, or certainly one of them. You
were in exactly that situation as a -- as a leader facing a tough
re-election race.

What do you make of Reid's chances? What advice do you have for him
in juggling those two -- those two problems, running for re-election and
keeping -- running your caucus?

DASCHLE: I think you've just got to do the right thing. That means
be the best leader you can be, the best senator from the state of Nevada
or South Dakota or Mississippi that you can be. Do what you've got to
do to lead this country as well as you can do it, for as long as the
people of your state give you that chance. And that's what Harry Reid
is doing.

KARL: I mean, he -- he -- what do you think? He's going to lose,
isn't he?

DASCHLE: I don't think so. I really think Harry Reid can turn this
around. I really do. I think, once health care passes -- and, you
know, and people start focusing on the other -- on the opposition, he's
-- he's as strong a competitor -- he's never lost -- he's lost one
election. And I have to tell you, he's -- he's a resilient political
leader.

DONALDSON: Jon, you'd have a real headline if Tom said no...

(CROSSTALK)

KARL: Predicting that Harry Reid was going to go out.

DONALDSON: Look, in the short run, the Democrats will lose seats in
November. In the long run, when people discover there is no death
panel, they're not going to cut basic Medicare, when I have my aortic
valve replaced next year, it will be the same, they're cutting the
subsidy for Medicare Advantage...

KARL: We've got 10 seconds.

(CROSSTALK)

LOTT: ... less health care, more taxes, more fees, more government
intervention. That's what they're going to really experience.

KARL: And there you have it. Besides, we are out of time. Thank
you very much, George Will, Trent Lott, Tom Daschle, Sam Donaldson.

(CROSSTALK)

KARL: The Roundtable will continue in the green room on
abcnews.com, where you can get all the political updates all week long
by signing up for our newsletter on abcnews.com.